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Celik D, Anaforoglu Kulunkoglu B. Photobiomodulation Therapy Versus Extracorporeal Shock Wave Therapy in the Treatment of Lateral Epicondylitis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:269-275. [DOI: 10.1089/photob.2018.4533] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Derya Celik
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Bahar Anaforoglu Kulunkoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
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Akkurt HE, Kocabaş H, Yılmaz H, Eser C, Şen Z, Erol K, Göksu H, Karaca G, Baktık S. Comparison of an epicondylitis bandage with a wrist orthosis in patients with lateral epicondylitis. Prosthet Orthot Int 2018; 42:599-605. [PMID: 29806569 DOI: 10.1177/0309364618774193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND: Lateral epicondylitis is one of the most common causes of elbow pain. It is generally observed in people between the ages of 40 and 50 years, and the dominant extremity is more frequently affected. Various noninvasive methods are frequently used; however, studies investigating the effectiveness of the orthoses are limited and with controversial outcomes. OBJECTIVE: To investigate the effectiveness of a hand-wrist resting orthosis and an epicondylitis bandage in lateral epicondylitis. STUDY DESIGN: Randomized controlled trial. METHODS: In total, 82 patients diagnosed with unilateral lateral epicondylitis were enrolled into the study. Hand-wrist resting orthosis was applied to 45 patients and epicondylitis bandage was applied to 41 patients. Patients were evaluated before treatment and at 6 weeks after treatment with a Visual Analogue Scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form 36; and a determination of hand grasping force. RESULTS: Both groups were similar in terms of age, body mass index, gender, frequency of lateral epicondylitis on the dominant side, dominant extremity, and duration of complaints ( p > 0.05). A statistically significant recovery was detected in both groups between the pre-therapy values and the values at the sixth week in terms of Visual Analogue Scale scores; Disabilities of the Arm, Shoulder, and Hand questionnarie scores; hand grasping forces; and the Short Form 36 mental and physical component scores ( p < 0.05). However, there were no significant differences detected between the two therapy methods before the therapy and at the sixth week of treatment in all parameter values ( p > 0.05). CONCLUSION: Our results suggest that both epicondylitis bandage and hand-wrist resting orthosis are effective treatment options for lateral epicondylitis-induced pain, functional status, muscle strength, and quality of life. Furthermore, neither treatment option was superior to the other. Large, randomized studies are necessary for more clear statements. CLINICAL RELEVANCE Epicondylitis bandage and hand-wrist resting orthosis are equally effective treatment options for lateral epicondylitis-induced pain, functional status, muscle strength, and quality of life.
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Affiliation(s)
| | - Hilal Kocabaş
- 2 Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Halim Yılmaz
- 1 Konya Education and Research Hospital, Konya, Turkey
| | - Cemile Eser
- 1 Konya Education and Research Hospital, Konya, Turkey
| | - Zafer Şen
- 1 Konya Education and Research Hospital, Konya, Turkey
| | - Kemal Erol
- 1 Konya Education and Research Hospital, Konya, Turkey
| | - Hamit Göksu
- 1 Konya Education and Research Hospital, Konya, Turkey
| | - Gülten Karaca
- 3 Faculty of Medicine, Kırıkklale University, Kırıkklale, Turkey
| | - Süleyman Baktık
- 2 Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Mamais I, Papadopoulos K, Lamnisos D, Stasinopoulos D. Effectiveness of Low Level Laser Therapy (LLLT) in the treatment of Lateral elbow tendinopathy (LET): an umbrella review. Laser Ther 2018; 27:174-186. [PMID: 32158063 PMCID: PMC7034252 DOI: 10.5978/islsm.27_18-or-16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The aim of this umbrella review is to determine the effectiveness of LLLT in the treatment of LET and to provide recommendations based on this evidence. METHODS A comprehensive and systematic review was undertaken using Medline, EBSCO and EMBASE. Systematic reviews or meta-analysis were included if they compared Laser with at least one of the following: (i) placebo, (ii) no treatment, (iii) another treatment, conservative (physical therapy intervention or medical) or operative of LET. Principal outcomes included the assessment of short and long-term effect on functional status, pain, grip strength (pain-free or maximum) and a global measure (overall improvement). RESULTS Seven papers met the inclusion criteria for the umbrella review, Five papers were of moderate and two of low methodological quality. All reviews reported benefits associated with laser therapy Vs other intervention or placebo, however the significance of the identified benefits differed between studies and reviews. No review reported negative effects of laser therapy or harm to patients. All reviews noted significant variance between included studies with 2 reviews citing statistically significant heterogeneity. It is essential to consider this in the interpretation of these data. CONCLUSION This umbrella review found poor results for the effectiveness of LLLT in the management of LET. Therefore, further research with well-designed RCTs is required to provide meaningful evidence on the effectiveness (absolute and relative) of LLLT for the management of LET.
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Affiliation(s)
- Ioannis Mamais
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens
| | - Konstantinos Papadopoulos
- Department of London Sports Institute, Science and Technology School, Middlesex University of London
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Demetrios Stasinopoulos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
- Director of Cyprus Musculoskeletal and Sports Trauma Research Centre (CYMUSTREC)
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Bjordal JM, Couppe C, Ljunggren AE. Low Level Laser Therapy for Tendinopathy. Evidence of A Dose–Response Pattern. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/ptr.2001.6.2.91] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Conforti M, Fachinetti GP. High power laser therapy treatment compared to simple segmental physical rehabilitation in whiplash injuries (1° and 2° grade of the Quebec Task Force classification) involving muscles and ligaments. Muscles Ligaments Tendons J 2013; 3:106-11. [PMID: 23888293 DOI: 10.11138/mltj/2013.3.2.106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION whiplash is a frequent post traumatic pathology caused by muscle, tendon and capsular elements over stretching. The authors conducted a short term prospective randomised study to test the effectiveness of a multi wave High Power Laser Therapy (HPLT) versus conventional simple segmental physical rehabilitation (PT) included in Italian tariff nomenclature performance physiotherapy Study Design: prospective randomised study (Level II). MATERIAL AND METHODS the authors identified 135 homogeneous patients with whiplash grade 1 - 2 of the Quebec Task Force classification (QTFC). INAIL, the Italian National Workers Insurance, based in Milan, was reliable source for identifying patients. All patients with whiplash injuries grade 1 or 2 QTFC, were eligible for the study, starting from April 28 2010 to September 30 2010. Patients referred to a Coordinator (C.M.) who applied the inclusion and exclusion criteria. Patients who agreed to participate were randomly assigned to one of the two treatment groups. Dates for initial treatment session were arranged, including cervical spine X-ray, and assessment. Each patient gave informed consent for participation and agreed to adopt only the study treatment for 6 weeks. Group A (84 patients) was treated with High Power Laser Therapy (HPLT), Group B (51 patients) received conventional simple segmental physical rehabilitation (PT). During the treatment period, no other electro-medical therapy, analgesics or anti-inflammatory drugs were allowed. All patients were assessed at baseline (T0) and at the end of the treatment period (T1) using a Visual Analogical Scale (VAS), (T2) the date of return to work was registered afterwards. RESULTS there was a reduction in VAS pain scores at T1. Group A (VAS = 20) Group B (VAS = 34,8) (p =0.0048). Laser treatment allowed quick recovery and return to work (T2). Group A after 48 days against 66 days of Group B (p=0.0005). CONCLUSIONS results suggest that High Power Laser Therapy - is an effective treatment in patients with whiplash injury, compared to conventional simple segmental physical rehabilitation.
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Bjordal JM, Lopes-Martins RA, Joensen J, Couppe C, Ljunggren AE, Stergioulas A, Johnson MI. A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow). BMC Musculoskelet Disord 2008; 9:75. [PMID: 18510742 PMCID: PMC2442599 DOI: 10.1186/1471-2474-9-75] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Accepted: 05/29/2008] [Indexed: 12/16/2022] Open
Abstract
Background Recent reviews have indicated that low level level laser therapy (LLLT) is ineffective in lateral elbow tendinopathy (LET) without assessing validity of treatment procedures and doses or the influence of prior steroid injections. Methods Systematic review with meta-analysis, with primary outcome measures of pain relief and/or global improvement and subgroup analyses of methodological quality, wavelengths and treatment procedures. Results 18 randomised placebo-controlled trials (RCTs) were identified with 13 RCTs (730 patients) meeting the criteria for meta-analysis. 12 RCTs satisfied half or more of the methodological criteria. Publication bias was detected by Egger's graphical test, which showed a negative direction of bias. Ten of the trials included patients with poor prognosis caused by failed steroid injections or other treatment failures, or long symptom duration or severe baseline pain. The weighted mean difference (WMD) for pain relief was 10.2 mm [95% CI: 3.0 to 17.5] and the RR for global improvement was 1.36 [1.16 to 1.60]. Trials which targeted acupuncture points reported negative results, as did trials with wavelengths 820, 830 and 1064 nm. In a subgroup of five trials with 904 nm lasers and one trial with 632 nm wavelength where the lateral elbow tendon insertions were directly irradiated, WMD for pain relief was 17.2 mm [95% CI: 8.5 to 25.9] and 14.0 mm [95% CI: 7.4 to 20.6] respectively, while RR for global pain improvement was only reported for 904 nm at 1.53 [95% CI: 1.28 to 1.83]. LLLT doses in this subgroup ranged between 0.5 and 7.2 Joules. Secondary outcome measures of painfree grip strength, pain pressure threshold, sick leave and follow-up data from 3 to 8 weeks after the end of treatment, showed consistently significant results in favour of the same LLLT subgroup (p < 0.02). No serious side-effects were reported. Conclusion LLLT administered with optimal doses of 904 nm and possibly 632 nm wavelengths directly to the lateral elbow tendon insertions, seem to offer short-term pain relief and less disability in LET, both alone and in conjunction with an exercise regimen. This finding contradicts the conclusions of previous reviews which failed to assess treatment procedures, wavelengths and optimal doses.
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Affiliation(s)
- Jan M Bjordal
- Institute of Physiotherapy, Faculty of Health and Social Sciences, Bergen University College, Moellendalsvn, 6, 5009 Bergen, Norway.
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Cetiner S, Kahraman SA, Yücetaş S. Evaluation of Low-Level Laser Therapy in the Treatment of Temporomandibular Disorders. Photomed Laser Surg 2006; 24:637-41. [PMID: 17069496 DOI: 10.1089/pho.2006.24.637] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess the effectiveness of low-level laser therapy (LLLT) in the treatment of myogenic originated temporomandibular disorders (TMD). BACKGROUND DATA Limited studies have demonstrated that LLLT may have a therapeutic effect on the treatment of TMD. METHODS Thirty-nine patients with myogenic TMD-associated orofacial pain, limited mandibular movements, chewing difficulties, and tender points were included in this study. Twenty-four of them were treated with LLLT for 10 sessions per day excluding weekends as test group, and 15 patients with the same protocol received placebo laser treatment as a control group. These parameters were assessed just before, just after, and 1 month after the treatment. RESULTS Maximal mouth-opening improvement, and reductions in pain and chewing difficulty were statistically significant in the test group when compared with the control group. Statistically significant improvements were also detected between two groups regarding reduction in the number of tender points. CONCLUSION Based on the results of this placebo-controlled report, LLLT is an appropriate treatment for TMD and should be considered as an alternative to other methods.
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Affiliation(s)
- Sedat Cetiner
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Gazi University, Ankara, Turkey.
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Stasinopoulos DI, Johnson MI. Effectiveness of low-level laser therapy for lateral elbow tendinopathy. Photomed Laser Surg 2005; 23:425-30. [PMID: 16144488 DOI: 10.1089/pho.2005.23.425] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Our aim was to determine the effectiveness of low-lever laser therapy (LLLT) in the management of lateral elbow tendinopathy (LET) and to provide recommendations based on this evidence. BACKGROUND DATA LET is a common clinical condition, and a wide array of physiotherapy treatments is used for treating LET. METHODS Randomized controlled trials (RCTs) identified by a search strategy in six databases were used in combination with reference checking. RCTs that included LLLT, patients with LET, and at least one of the clinically relevant outcome measure were selected. Aqualitative analysis of the selected studies was conducted using the Chalmers' technique. RESULTS Nine RCTs fulfilled the criteria and were included in the review. Although these studies had satisfactory methodology, shortcomings were not absent; poor results were revealed as to the effectiveness of LLLT for LET management. CONCLUSIONS LLLT need not be ruled out for LET as it is a dose-response modality, and the optimal treatment dose has obviously not yet have been discovered. Further research with well-designed RCTs is needed to establish the absolute and relative effectiveness of this intervention for LET.
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Stasinopoulos D. The Use of Polarized Polychromatic Non-coherent Light as Therapy for Acute Tennis Elbow/Lateral Epicondylalgia: A Pilot Study. Photomed Laser Surg 2005; 23:66-9. [PMID: 15782036 DOI: 10.1089/pho.2005.23.66] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the efficacy of polarized, polychromatic, non-coherent, low energy light (Bioptron 2, Bioptron AG, Switzerland) in the treatment of acute tennis elbow. BACKGROUND Tennis elbow, or lateral epicondylitis, is one of the most common lesions affecting the arm. A plethora of treatment regimes have been described for this condition, but no specific therapy has emerged as a gold standard. METHODS A pilot study was carried out with 25 patients who had acute tennis elbow. Bioptron 2 device was applied over lateral epicondyle three times per week for 4 weeks. Pain on VAS, function on VAS, and painfree grip strength were measured at the beginning (week 0) and at the end of the study (week 4). RESULTS The pain on VAS was reduced at the end of treatment (t(24) = 3.84, p = 0.001). Function on VAS was increased at the end of treatment (t(24) = 4.23, p < 0.001). Pain-free grip strength was increased at the end of treatment (t(24) = 4.23, p < 0.004). CONCLUSION Although the results suggested that the Bioptron 2 could reduce patients' symptoms with acute tennis elbow, future controlled studies are needed to establish the relative and absolute effectiveness of Bioptron 2.
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Irvine J, Chong SL, Amirjani N, Chan KM. Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome. Muscle Nerve 2004; 30:182-7. [PMID: 15266633 DOI: 10.1002/mus.20095] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Several studies have suggested that low-level laser therapy (LLLT) is effective in patients with carpal tunnel syndrome (CTS). In a double-blind randomized controlled trial of LLLT, 15 CTS patients, 34 to 67 years of age, were randomly assigned to either the control group (n = 8) or treatment group (n =7). Both groups were treated three times per week for 5 weeks. Those in the treatment group received 860 nm galium/aluminum/arsenide laser at a dosage of 6 J/cm2 over the carpal tunnel, whereas those in the control group were treated with sham laser. The primary outcome measure was the Levine Carpal Tunnel Syndrome Questionnaire, and the secondary outcome measures were electrophysiological data and the Purdue pegboard test. All patients completed the study without adverse effects. There was a significant symptomatic improvement in both the control (P = 0.034) and treatment (P =0.043) groups. However, there was no significant difference in any of the outcome measures between the two groups. Thus, LLLT is no more effective in the reduction of symptoms of CTS than is sham treatment.
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Affiliation(s)
- Jamie Irvine
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta, Canada
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Gur A, Cosut A, Sarac AJ, Cevik R, Nas K, Uyar A. Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: A double-blind and randomized-controlled trial. Lasers Surg Med 2003; 33:330-8. [PMID: 14677160 DOI: 10.1002/lsm.10236] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES A prospective, double-blind, randomized, and controlled trial was conducted in patients with knee osteoarthritis (OA) to evaluate the efficacy of infrared low-power Gallium-Arsenide (Ga-As) laser therapy (LPLT) and compared two different laser therapy regimes. STUDY DESIGN/MATERIALS AND METHODS Ninety patients were randomly assigned to three treatment groups by one of the nontreating authors by drawing 1 of 90 envelopes labeled 'A' (Group I: actual LPLT consisted of 5 minutes, 3 J total dose + exercise; 30 patients), 'B' (Group II: actual LPLT consisted of 3 minutes, 2 J total dose + exercise; 30 patients), and 'C' (Group III: placebo laser group + exercise; 30 patients). All patients received a total of 10 treatments, and exercise therapy program was continued during study (14 weeks). Subjects, physician, and data analysts were unaware of the code for active or placebo laser until the data analysis was complete. All patients were evaluated with respect to pain, degree of active knee flexion, duration of morning stiffness, painless walking distance and duration, and the Western Ontario and Mc Master Universities Osteoarthritis Index (WOMAC) at week 0, 6, 10, and 14. RESULTS Statistically significant improvements were indicated in respect to all parameters such as pain, function, and quality of life (QoL) measures in the post-therapy period compared to pre-therapy in both active laser groups (P < 0.01). Improvements in all parameters of the Group I and in parameters, such as pain and WOMAC of the Group II, were more statistically significant when compared with placebo laser group (P < 0.05). CONCLUSIONS Our study demonstrated that applications of LPLT in different dose and duration have not affected results and both therapy regimes were a safe and effective method in treatment of knee OA.
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Affiliation(s)
- Ali Gur
- Physical Medicine and Rehabilitation, School of Medicine, Dicle University, Diyarbakir, Turkey.
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Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med 2003; 32:233-8. [PMID: 12605431 DOI: 10.1002/lsm.10134] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to determine whether low power laser therapy (Gallium-Arsenide) is useful or not for the therapy of chronic low back pain (LBP). STUDY DESIGN/MATERIALS AND METHODS This study included 75 patients (laser + exercise-25, laser alone-25, and exercise alone-25) with LBP. Visual analogue scale (VAS), Schober test, flexion and lateral flexion measures, Roland Disability Questionnaire (RDQ) and Modified Oswestry Disability Questionnaire (MODQ) were used in the clinical and functional evaluations pre and post therapeutically. A physician, who was not aware of the therapy undertaken, evaluated the patients. RESULTS Significant improvements were noted in all groups with respect to all outcome parameters, except lateral flexion (P < 0.05). CONCLUSIONS Low power laser therapy seemed to be an effective method in reducing pain and functional disability in the therapy of chronic LBP.
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Affiliation(s)
- Ali Gur
- Physical Medicine and Rehabilitation, School of Medicine, Dicle University, Diyarbakir, Turkey.
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Sharma R, Thukral A, Kumar S, Bhargava SK. Effect of Low Level Lasers in de Quervains Tenosynovitis. Physiotherapy 2002. [DOI: 10.1016/s0031-9406(05)60716-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chow RT. DOSE DILEMMAS IN LOW LEVEL LASER THERAPY - THE EFFECTS OF DIFFERENT PARADIGMS AND HISTORICAL PERSPECTIVES. Laser Ther 2000. [DOI: 10.5978/islsm.13.102] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
Despite more than 30 years of experience with low level laser therapy (LLLT) or 'biostimulation' in dentistry, concerns remain as to its effectiveness as a treatment modality. Controlled clinical studies have demonstrated that while LLLT is effective for some specific applications, it is not a panacea. This paper provides an outline of the biological basis of LLLT and summarizes the findings of controlled clinical studies of the use of LLLT for specific soft tissue applications in dentistry. Areas of controversy where there is a pressing need for further research are identified.
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Affiliation(s)
- L J Walsh
- Department of Dentistry, University of Queensland
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Goats GC, Hunter JA, Flett E, Stirling A. Low Intensity Laser and Phototherapy for Rheumatoid Arthritis. Physiotherapy 1996. [DOI: 10.1016/s0031-9406(05)66866-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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